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General NPI Number Information
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NPI Number | 1700931565
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Entity Type | Individual
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Provider Name | RAVINA STURGEON O.D.
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Gender | Female
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8201 N FM 620
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City | AUSTIN
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State | TX
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Zip | 78726
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Country | US
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Telephone | 512-328-2015
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Fax | 512-996-0477
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Provider Business Mailing Address
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Address Line | 11425 DONA VILLA DR.
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City | AUSTIN
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State | TX
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Zip | 78726-1727
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Country | US
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Telephone | 512-535-0137
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Fax | 512-996-0477
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 6881T
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License Number State | TX
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